Want to get pregnant? There’s more to it than you think

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protect together. Power a truly independent press support the NPR network at plus.npr.org. It's so interesting to me how we think about pregnancy and sex like if you don't want to get pregnant, it feels like it could happen so easily. Basically, if you let your guard down at all, yeah, as a woman, especially like my whole life, you know, I'm thinking about that very first sex ed class that I

think was like in seventh grade, the messaging was like, it is so easy to get pregnant no matter how careful you are, no matter how much protection you use, you know, if someone just looks at you a little too long or whatever. Yeah, or

you're like in a hot tub with a boy. Yeah, but yeah, then for a lot of women

when the switch flips and they're actually ready to get pregnant, it doesn't happen right away. And I like, what's going on? Which is why we're doing this whole

“episode about what it actually takes to get pregnant through sex. By the way,”

you're listening to LifeKit, I'm Mary El Sigadra, and I'm talking to like care reporter Andy Tagle. That's right. And there's more to getting pregnant than you think. For some people, it can be that simple, but everyone's going to have a different experience based on a lot of different factors. To give you an idea from a statistical standpoint, at what's considered peak fertility,

we're talking about people in their early 20s to early 30s having regular unprotected sex to try and conceive, you only have around a 25 to 30% chance of getting pregnant in any given month. Wow, I've been lied to. I know, isn't that. I was shocked by this. But as the experts that I talked to told me that huge gap between what you're taught in high school or middle school, and

what you actually experience when you're trying to conceive can be really drawing for a lot of people. Here's reproductive endocrinologist Dr. Leckie Sigadra. A lot of people feel like their bodies are broken or that they've done something wrong. I've had patients even say, is it because I drank too much

“in college, and I think it is a very natural human nature tendency”

especially for women. I might add to kind of internalize things and blame themselves and take on more responsibility for things when in reality so much of our fertility is not in our control. That's actually really helpful to know, because I can hard relate to that saying, is it because I drank too much in college? Did I cause this problem? Right. Is it me? But you know,

Mario, one antidote to feeling disempowered is information. And this episode is absolutely fertile with no help. That can help if you're thinking about getting pregnant. All right, what are some of the topics you're going to get into? We'll do a little conception science crash course. We're going to cover the basic factors that can and cannot affect your ability to get pregnant. We're

going to help you think about your timing. Lots of thoughts more. That's coming up after the break. This week on Shortwave, could your next ride to the airport be in a flying taxi? So you open up your Uber app and you got Uber X and Uber Pet and now they'll be your career. That reality may be only a few years away, but how is this futuristic travel possible? Find out on

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Listen on the NPR app or wherever you get podcasts. We're having such a sports summer. The New York next one, the ambient ship, the World Cup is in full swing and a new season of Love Island has brought us back into the villa. On it's been a minute, we talk about how this summer we're all coming together to root for our favorites, sports teams and our favorite

couples. Listen to it's been a minute on the NPR app or wherever you get your

podcasts. A lot of us have basically a mini beauty product store in our bathrooms

and it's easy to feel like if you don't use the right serums, creams, acids,

those products? Life kit made a special newsletter series to help you figure out your skin care goals and what you actually need. Sign up at npr.org/scincare or find the link in the description for this episode. One thing I do want to quickly note upfront for listeners. This episode is going to focus on the so-called traditional way to make a baby meaning through heterosexual

intercourse. We want a knowledge of course, there are lots of ways to make a baby and endless ways to make a family. And we plan to give that non-traditional baby making its own spotlight with a companion episode to this one in the near future. So keep it near out. All right, I'm pretty sure I know why a lot of you are listening right now. So let's cut to the chase. Do you want to know when

“you should start trying? Right? You want to know if you need to worry? Like, if”

you were to walk into your doctor's office, you might say, "I'm not ready yet." But I want you to do whatever testing you can and I want you to tell me if I'm good and how long it'll be good for and I just want to make sure I'm not going to have any issues. That was Dr. Lucky Seacon again. She's a New York City based infertility expert and author of the aptly named New book The Lucky Egg,

which is a fertility guide book of sorts. Lucky says she gets this request from

patients all the time and it's great to plan ahead, but the problem is there's

no such thing as an all-encompassing female fertility test. Sorry to break it to you. No nasal swab? No blood drop. The best test for fertility is to try, which is the most annoying unhelpful answer, right? But it's kind of this confluence of factors and you have to actually try and see how those factors

“come together. The first of those factors you need to understand is the process”

of reproduction itself because it can be tricky. Each egg that you ovulate each month is kind of like a long shot. So if you like I need to get that put on t-shirts because it's like one of my slogans at this point and that leads us to our bit of a downer, but crucial to know upfront take away one. Human reproduction is inefficient and not totally in your hands. I talk about in my book as being a

sort of reproductive slot machine where pulling the lever is timing when to try, but whether everything after that lines up is so out of our control. This part, ovulation, I'm assuming you already know about. Every cycle, a single egg cell, chosen at random, travels down in the Philippian tube where it can live for 12 to 24 hours. Around that time or a little before, you want to shoot

some millions of sperm cells up the vagina through the cervix to meet it. Those guys can live in the reproductive tract for about three to five days. So there's this very narrow fertile window. This narrow window of opportunity each cycle but get this. Just getting the egg in sperm in the right place at the right time doesn't guarantee a connection will take place. It's like saying, going on a

date guarantees you're going to find your life partner. That's not true. And the same is true of the chemistry between the egg in the sperm and it's like

maybe 70, 80 percent of the time the timing is right and egg might fertilize

successfully. This is extrapolation from what we see in an IVF lab where we really try to orchestrate that meeting happening. If sperm and egg do hit it off, there's still a few more hurdles before you've made it to the finish line. Only about half of the time a fertilized egg will continue to grow and make it to the next step, which is called the blastocystage. It takes about a week. That

blastocyst then also has to find its way to the uterus. Sometimes it gets lost along the way and once it arrives at the uterus, it has to implant and keep growing there. And so it takes a lot of energy and a lot of them just don't make it to that stage. So suffice it to say there's a lot that has to go right in order to get pregnant. It is no exaggeration to call it the miracle

of life. And I know that all might feel a bit discouraging or intimidating, but it might help you set more realistic expectations. Minimize any shame and blame if you understand upfront what the odds are. According to the American Society for

Reproductive Medicine, approximately 80 percent of healthy heterosexual couples

will conceive in the first six months of attempting pregnancy. From there stats vary a bit, but some recent cumulative conception research has shown some 85 to 90 percent will conceive within a year and 95 percent will get pregnant within two

“years. So your next question, of course, what do you need to get pregnant when you”

want to? Like should you be running straight to your OB guidance office right this very minute? You know what I like? I like before even going to a doctor. It's

Dr. Sarah Orick is a mother of three and a reproductive psychiatrist, which means that I specialize in how female reproductive hormones impact mental health throughout the life cycle. She brings us to a quick takeaway too. To track a true period, get off a hormonal birth control. Now, tracking your cycle isn't hard to do. You start by

just marking the first day of your period on a calendar. But this might be a

“bigger ask for some than others. Because in order to track your period, you have to”

have one and a true period at that. Not just the light or complete lack of a period, you might enjoy if you have an ID, the regular spotting you might get with a depot shot or what's called withdrawal bleeding, which is actually just a reaction to a drop in hormones, not a result of ovulation. If you're using the pill, the patch or a vaginal ring. So, if you're using a hormonal birth control method, like other millions

of American women, this first, so called simple step, might be less so. You may find that the hormonal birth control was sometimes helping your mood. If you potentially had more pre-menstrual symptoms, some of those might come back. I was helping my skin a lot and I hadn't realized. It might not be super fun to remove the barrier to a lot of pain, discomfort

or oily skin, but it can be extremely useful. Even critical to your future reproductive

health, to get an idea of your sensitivity to hormones. Maybe, for example, you find you have really significant mood symptoms in the two weeks before your period. There's a chance you have PMS. There's a chance you have pre-menstrual dysphoric disorder, which is like really escalated mood symptoms during that time, and having all that information is

“actually important because sometimes that PMDD can kind of have you in a risk bucket for”

maybe increased risk of pregnancy or postpartum depression or anxiety. Another thing about getting off of birth control, with the exception of the depot pervera shot, you're going to want to consult your doctor. This is your chosen method. You don't have to plan for any ramp up time. I'm getting off of it. Most people getting off of the pill will get their period pretty much within a month or so. Now, I should say this isn't

a hard and fast rule. Like if you've been on birth control for decades, lucky says there is a minority of people that might need somewhere between three to six months to get their petuitaries to fully wake up and get back to work. So to speak. Having said that, there are many people whose bodies will just snap back into the normal routine, and so unless you're prepared to get pregnant or you're prepared to use a backup

method, like condoms, don't get off the pill. If you're using it for contraception, copy that. All right. Now that you've brought back get flow, let's learn what she has to share. Take away three. Track your menstrual cycle, recluse about your reproductive health. Sarah says there are a few good reasons why anyone with a uterus should track their menstruation. For one, if you do want to start trying for a baby soon, once you have a general sense of the

length of your menstrual cycle, it should be easier to pinpoint when you're ovulating. Which generally happens around two weeks before the start of your next period. Start to learn. Do I have a 26-day cycle? Do I have a 29 is-mind-pretty regular? I say like even by ovulation test kits, and see if you ovulate. Check in with your body for signs and then track them. One way you might have heard of is through your basal body temperature, which is just

the temperature of your body when it's fully at rest. You want to take it every day as soon as you wake up and then monitor for changes. Because when you ovulate, your basal body temp will increase slightly. And we're talking super slight here, like from 98 degrees to 98.5 degrees. And ovulation is likely over when that high temperature has stuck around for three days or more.

“Another way to tell. Learning what your cervical mucus changes. I mean, I think many of”

a ceiling, I was on things kind of different. But if you have that sort of a white textured cervical mucus that it's likely that you're ovulating. Another important reason to track is to

spot and get ahead of any potential problem areas. For example, if you always get terrible cramps

or your period never arrives on time, that could be signaling something about your ability to get pregnant in the future. If they start to note early on, that these patterns are thrown off and there really isn't a pattern. This tells us that it could be more challenging and it makes sense to get to the bottom of what's going on now so that you have a plan to hit the ground running with once you are in a position to start trying. Heavy irregular or painful periods could

point to potential threats to fertility, like enemy triosis or polyps or PMOS, formerly known as PCOS, or these symptoms could be no problem at all. But you can't know until you start tracking. So do you have that first day of your period marked? Good. Now, just do it again. Give yourself at least three months, four months of tracking your cycle and collecting data to really be able

notes in your plan are a fine way to start. But there are lots of online tools that can help you

too, of course. If you go this route, be sure to note up front how any interface will use and share your personal medical data. There are apps that can lock symptoms, predict fertility, help you spot patterns, even share your cycle tracking with a partner. Which reminds me. This far, we've really only been talking about the person who carries the baby. But as we know, they're only half

“of this equation. I think boys should be educated around all of these issues as well, and then when”

it comes to fertility, it's really important to note that about 50% is male factor in fertility. Male reproductive health. We'll jump into that after the break. Every story from shortwave and pure science podcasts starts with a question. Like, why do we have nightmares? How does AI affect my energy bill? At NPR, we are here for your right to be curious about the world around you. Follow shortwave wherever you get your podcast, because the more you ask,

the more interesting the world gets. It was thing to like it, and it's time for takeaway for. Fertility is 50/50. Both sides can make lifestyle choices to boost their odds. So let's talk sperm, shall we? Where female fertility remains at least somewhat of a question mark until go time,

“I'll expand on that in a bit. Male fertility is extremely testable, largely non-invasive,”

and the big one here is that a lot of the things that we see are reversible. Maybe you go into get tested, and your doctor says you have low motility, or tells you that your sperm count is lower

than the minimum threshold of 15 million sperm per milliliter. I've had couples where the husband was

like a professional biker, and that repetitive stress in that area, we think led to lower sperm quality, and they'll say okay I'm going to stop doing this. Then lucky we'll retest two or three months later and see a big turnaround in the quality of this sample. Some other potentially reversible lifestyle factors for men, testicular trauma, overly tight underwear, or other similar chronic skeletal exposure to heat. And yes, the rumors are true, cannabis.

Research shows cannabis is strongly linked to reduce sperm count and concentration, but the effects aren't permanent. The same goes for excessive alcohol consumption, and nicotine and all forms. Top of the list for women who want to get pregnant in the near future is taking a daily prenatal vitamin, starting at least one to three months before trying to conceive. Ingredients to look for include folic acid, iron, and DHA. All right, so now let's jump into

lifestyle factors for both men and women. To start, general rule of them. Whatever is better for heart health is typically going to be better and protective when it comes to your fertility, and also optimal in terms of setting you up for the healthiest pregnancy possible. You want to try to get in that recommended 150 minutes of exercise a week, keep stress levels low, and follow a heart healthy diet as best you can. You know, eat the rainbow, and from

Mediterranean style, high protein, low carb, lots of leafy green vegetables. Treating food as

“medicine is a real thing, and I think, you know, making sure that you are getting enough protein”

enough fiber because that actually helps stabilize your blood sugar. Lucky says this bit in particular can be impactful to fertility if you have a uterus. Because if you're turning out too much insulin, it can act like a growth factor on the ovaries. It can cause your ovaries to overproduce testosterone, and when an egg is going through an ovulation cycle, and again, when it gets fertilized, it's actually undergoing a massive amount of genetic reorganization, and that's where

those errors happen. This is important advice for men too. Maybe you've heard that mountain dew or other sodas can shrink your sperm count. That's a myth. No research shows direct links to caffeine intake and fertility, but consuming lots of sugary drinks. Not a good idea for that blood sugar. Lastly, what about environmental factors? BPAs, pesticides, heavy metals, and air pollution have all been shown to disrupt hormonal balances, which can in turn affect fertility overall.

So do what you can, but also know you can only do what you can, because at the end of the day, as Lucky says, fertility isn't logical. There's no single lifestyle factor or something that they

did, which we can say. This is the cause of that. At the end of the day, it's never someone's fault,

and it's very, very unfair. And the thing is, yeah, just don't know where you fall until you know. Take away five. timing conception is an educated guess at best. The only true way to test

Let's take those in reverse. Fertility red flag number one, genetic makeup. So if you have

“a regular heavy or painful cycles, hopefully you have a good idea of that one now, or a strongly”

history of any other major gynecological issues. Whether that be endometriosis, fibroids, PCOS,

there's a major irritability factor there. If you have a first degree relative with some of these

issues, it increases your personal risk by several folds. Next, timing. If you're healthy and under 35, it's recommended you try to get pregnant on your own for at least one full year before seeking out any infertility treatments. If you're 35 and older, you shouldn't wait longer than six months. And if you're in your 40s, you shouldn't wait longer than the three month mark, which brings us to our last factor. And the TikTok, TikTok of that pesky biological clock.

A lot of people think of turning 35, like being Cinderella at the ball. And it's like poof. Now, you know, your carriage turns into a pumpkin, and that's just not what it is. Why age 35 matters, according to Lucky, is that it's considered a turning point. So if you get a map out on a chart, the health of your egg cells through your lifespan, age 35 is when you start to see a downward slope. And what's happening is the protein that keeps the chromosomes

in your egg cells lined up correctly, slowly break down with each. But I want to say that nobody has perfect eggs. And even in our 20s, 20 to 25% of embryos will have missing or extra DNA. And that increases to about maybe a third of them at 35 by 37 or 38. Your odds are more like a coin flip. 50, 50. Now at 40, this is where the coin flip. It's like a weighted coin and it's flipping in the negative direction. At this point, the split is 70, 30, meaning up to 70% of the time,

an egg cell will have missing or extra DNA. So it's going to be harder to have a viable pregnancy naturally. The other age component you might have heard about is the number of eggs you have available.

A count is always decreasing, and it tends to decrease more rapidly around 35. And by the way,

sperm age is too, a little differently, but motility can start to decrease after 30, for example.

“And this is likely an important consideration if you're planning on assisted reproduction of some kind.”

Egg or embryo freezing or IVF, where egg harvesting is necessary. Because the more eggs I have to work with, the better the chance of getting what I need out of a given treatment cycle. We actually have a whole episode on egg freezing that can give you a lot more in that process, if you're interested. And if you just want to arm yourself with as much information as humanly possible, there is one thing you can test that can provide some insight on the state of your

egg reserve. It's called AMH, or anti-malarian hormone. It's a hormone produced by the small developing egg follicles and your ovaries. But if you do get it tested, be careful with some of those numbers because it's a full clinical picture that's really important. Sarah says, it can be tempting to put all your eggs in one basket, so to speak. To think of, say, egg or even embryo freezing as an insurance policy, or maybe a low egg reserve as a sign that you have no chance

of conceiving. But you can't just use one outcome or one data point to kind of influence your all of your decision-making. Sarah took the test and found she had low AMH, for example. Those test results helped her and her partner make the calculation to start trying sooner rather than later. If I didn't have a partner for example, maybe I would have frozen my eggs, and that would have made sense to me and felt like, okay, this is right.

Lucky had her first child the traditional way, then decided to freeze embryos at age 34.

When she struggled to get pregnant again in her late 30s, she used those embryos to have her second child, which is all just to say, there's no one size fits all here. And unfortunately, no magic calculator to tell you the perfect time to start trying. But hopefully you now have a starting point or two from making this decision yourself. So you've tracked your cycle, you've cultivated your ideal baby-making environment, you figured out exactly what you want to

start trying. What's left on the checklist? Well, nothing to it, but to do it. Take away six. Don't beat around the baby-making bush. Before we leave you to go for the multiply, a few last tips for some successful sexy time. First up, don't do what I just did and lead with any window. Be direct about the change to your sex life. That doesn't mean it has to be a chore. Just setting expectations can be so important.

“I think we should, you know, have sex during these days of my ovulation window. Maybe we can plan some”

dates. Now, how often should you be trying? Every day of the month, first thing in the morning,

leading up to ovulation and the day of ovulation itself." So you could have sex every day of the month,

but rather than burning yourself out, unless, I mean, there are obviously some people out there that, like, this is what they would be doing anyway. I don't know those people. So your best bet, sex on a daily basis, the five days leading up to and including the day of ovulation.

“Another thing you might have heard is that you should save up all those swimmers until that window,”

you know, hold out so that your sperm is extra strong. Nope. If you are abstinant for too long over a week, you can actually build up dead, old sperm cells. They need to get out, right? And so

we actually recommend that they ejaculate at least within a week. That simple schedule should put

you in a good position to make a baby. And hey, now that we're on the topic doc, is there a best baby making position? Like before, during, after, there are no sexual positions that are more effective at helping you get pregnant than others. You don't have to have an orgasm. You do not need bed rest. You don't need to be in a certain position. So that covers the mechanics. A final tip, if you dare, try to enjoy the process together. I think it's also a nice time to reevaluate

and people. I don't think do this enough of like what turns you on. Was that, you know, intimacy, meaning, you know, chores done at home. Does that mean a date? You know, really assessing that for yourselves and being able to come together and how can we make this still meet some of the criteria, even though there's some gold directed aspect. Okay, team. Let's recap. Take away one. Human reproduction is inefficient. And some of it just comes down to luck. Take away two. To

track your period, you'll need to get off a hormone over control. Bracers off. Take away three.

“Get to know your cycle. It's important information whether or not you're ready to start trying.”

Take away four. Fritility is 50/50. Both sides can make lifestyle choices to boost your odds. Take away five. There's no way to fully test female fertility, but factors like age, timing, and genetics can guide you to an educated decision about when to start trying.

And finally, take away six. Trying to make a baby is probably going to change your sex life.

Why not have some fun along the way? That was life care reporter Andy Tagle. Before we go, would you take a moment to rate and review us? How is a favorite tip that you learned or tell us what kind of episodes you like best? We love hearing from you and when you leave her review, it helps the show grow. This episode of Life Kit was produced by Phil V Douglas. Our digital editor is Mala Cagoreave and our visuals editor is CJ Rekuan.

Megan Kane is our senior supervising editor and Lauren Gonzalez is our executive producer. Our production team also includes clamouration writer and Margaret Serino, engineering support comes with Scenola Frateau, backpacking by Tyler Jones. Special thanks to Mariah Goodman. I'm Mariah Cigada. Thanks, Postman.

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